快速进展的痴呆诊治进展.ppt

Imaging: Initial Screen 影像学初筛 Imaging Brain MRI (including T1, T2,fluid-attenuated inversion recovery[FLAIR], diffusion-weighted imaging, apparent diffusion coefficient map, hemosiderin sequence) with and without contrast MRI检查（包括T1,T2,FLAIR, DWI, ADC,磁敏感序列 及增强） Chest x-ray (if clinically indicated) 胸部X线 RPD 初步筛查试验Recommended Initial Screening Tests for Evaluation of a Rapidly Progressive Dementia Imaging : Secondary Tier (Depending on Initial Screenand Clinical Scenario) 影像学：进一步筛查 CT head 头颅CT CT chest, abdomen, and pelvis with and without contrast 胸部、腹部及盆腔CT（平扫或增强） Magnetic resonance angiography/magnetic resonance venography MRA或MRV Computed tomography angiography/brain angiogram CTA或脑血管造影 RPD 初步筛查试验Recommended Initial Screening Tests for Evaluation of a Rapidly Progressive Dementia Magnetic resonance spectroscopy (for lesionsor masses) 磁共振波普分析 Mammogram 乳腺X线片 Body fluorodeoxyglucose positron emission tomography (FDG-PET)/CT scan 氟脱氧葡糖 PET扫描 Testicular or pelvic ultrasound 睾丸及子宫超声 Carotid ultrasound 颈动脉超声 Echocardiogram 心脏超声 RPD Imaging : Secondary Tier (Depending on Initial Screenand Clinical Scenario) 影像学：进一步筛查 Other tests：Initial Screen EEG 脑电图 Other tests： Secondary Tier Electromyogram/nerve conduction study 肌电图/神经传导速度 Ophthalmologic examination or vitreous sampling (eg, for lymphoma) 眼科检查或玻璃体采样检查淋巴瘤 Brain biopsy with or without meningeal biopsy(especially if above tests are nondiagnostic) 脑活检（尤其上述所有方法不能明确诊断） 其它筛查：RPD 初步筛查试验 小 结 In most larger rapidly progressive dementia series, the most common causes of rapidly progressive dementia are nonprion neurodegenerative diseases, prion diseases, and autoimmune/antibody-mediated encephalopathies. 在RPD系列研究中，RPD最常见的病因是非朊蛋白病导致的神经退行性疾病、朊蛋白病、自身免疫介导的脑病； Sending the CSF biomarkers 14-3-3, total tau, and neuron-specific enolase is always recommended, not necessarily as diagnostic tests for prion disease, because they are not, but rather as markers of rapid neuronal injury. If these